It’s that time of year again. The October chills bring with them influenza season, but this year the flu is still a bit complicated with the ongoing pandemic. Because 57% of the nation is now fully vaccinated against COVID-19, masking and social distancing may feel confusing with the reopening of in-person instruction and activities. To help you navigate these new rules, The Daily created a guide to answer all of your flu-related questions in the context of COVID-19.

Flu Trends

When is flu season?

While anyone can contract the flu year round, its viral activity in the United States starts to increase in October. Infection rates spike in the winter months, from December to February, and activity wanes out as late as May. The best way to reduce the risk of symptoms, hospitalization or death by flu infection is through getting the flu vaccination by the end of October.

How will this year’s flu season compare to that in the last few years?

During the 2019-20 season, 38 million people in the U.S. contracted the flu with an estimated 400,000 of those hospitalized and 22,000 who died. Stable estimates were not made for the 2020-21 season due to low hospitalization rates and 736 recorded deaths attributed to the flu, which were its lowest numbers since current reporting measures began in 1997. However, these low numbers have been attributed to public health guidelines put into place for the pandemic. With more relaxed measures currently in place, along with “pandemic fatigue,” there’s potential for this season’s flu activity to be more severe than the last.

The flu vaccine

How does it work?

All flu vaccines are quadrivalent, which means they demonstrate effectiveness against four major influenza A and B strains to circulate in the 2021-22 season. The flu viruses change yearly, and vaccines are changed accordingly to provide maximum protection for the consequent year.

There are three types of Federal Drug Administration-approved quadrivalent flu vaccines available with similar efficacy rates. Egg-based vaccines include weakened (not infectious), inactivated viral injections — essentially, killed — as well as nasal sprays that contain harvested viral fluid from fertilized hen eggs. Cell-based flu vaccines are similarly produced, except viral fluid was harvested from cultured mammalian cells rather than eggs. As inactivated flu vaccines, they imitate infection, without causing illness, in order to help your body build immunity in the case of real infection.

A third flu vaccine, like the COVID-19 vaccines, was created from recombinant technology. The fastest of the three to produce, this option synthetically triggers antibody production by providing the genetic instructions for a protein found on flu viruses through with secondary virus  — called a vector — that does not cause infection. In essence, this type of vaccine helps the cells recognize a virus and prepare an immune response in the case of infection.

Who should get it and is it safe?

The Centers for Disease Control and Prevention recommend every individual six months and older receive a flu vaccine each year. People with severe allergies to any of the ingredients — including eggs — may still be able to get a vaccine, but should consult a medical professional for further guidance. Flu vaccination should be deferred for individuals who have tested positive for COVID-19 or may have contracted it until after the recommended isolation period ends.

The CDC says the quadrivalent flu vaccines are safe and are monitored annually for their safety and effectiveness. The flu vaccine and the nasal spray cannot give you the flu. Those containing inactivated strains are non-infectious with the sole purpose of helping your body produce antibodies in the case of infection.

All three vaccine types may produce mild and short-lasting side effects including soreness at the site of injection, headache, fever or nausea.

Where can I get it?

You can consult your medical provider or get a free flu vaccine from Evanston pharmacies such as CVS, Jewel-Osco and Walgreens. Most pharmacies are accepting walk-in appointments.

Some pharmacies in Evanston providing flu shots are:

— CVS Pharmacy, 1711 Sherman Ave.

— CVS Pharmacy, 1616 Sherman Ave.

— Jewel-Osco Pharmacy, 1128 Chicago Ave.

— CVS Pharmacy, 101 Asbury Ave.

COVID-19 and the flu

What is the difference between the spread of COVID-19 and the flu?

Both COVID-19 and flu viruses are spread through respiratory droplets from coughing, sneezing or talking, though COVID-19 has shown to be much more contagious. Both COVID-19 and the flu have overlapping symptoms, such as fever, sore throat, nasal congestion, headache and cough, so self-diagnosing based on visible symptoms alone may not be accurate. 

The onset of symptoms may also appear later and longer for COVID-19 than the flu. You may experience symptoms between one and four days after exposure to influenza viruses, while symptoms may appear between two and 14 days after exposure to COVID-19. To get a more definitive diagnosis, you should seek testing for both viruses. 

Can I have COVID-19 and the flu at the same time? What about their vaccines?

Receiving the COVID-19 vaccine does not protect you against the influenza viruses and vice versa. You can also get both the flu shot and a COVID-19 vaccine or booster shot simultaneously. While masking and social distancing practices aid in protection against the influenza viruses, vaccination is the best way to reduce risk for yourself and others you come into contact with.

It is also possible to contract both viruses simultaneously. As of July 2020, the FDA granted an Emergency Use Authorization for the CDC Influenza SARS-CoV-2 (Flu SC2) Multiplex Assay, an RT-PCR test that can simultaneously detect and distinguish SARS-CoV-2, influenza A and influenza B viruses. Last month, the FDA approved the use of Labcorp SARS-CoV-2 & Influenza A/B Assay, a similar test that allows individuals to test for the three viral strains at home.

What treatment options exist?

While vaccines for both viral infections can only serve as a preventative measure, treatment options exist for the influenza virus. As of now, there are four FDA-approved prescription medications for the flu, including Tamiflu and Relenza.

For COVID-19, the FDA has approved one antiviral drug, Remdesivir, to be used only in health care settings for severe cases. The FDA has also issued EUAs — an authorization for emergency medical measures in the case of public health crises — for several monoclonal antibody treatments for mild and moderate cases in individuals 12 and older who are at risk of worsening symptoms. This treatment supplements the immune system’s response to produce antibodies to fight infection by providing synthetically-made antibodies.

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